Trends and Disparities in Suicidal Thoughts and Behaviors and Mental Health Symptoms Among Sexual and Gender Minority College Students in the U.S., 2008–2018
This study uses data from the National College Health Assessment (NCHA) to examine trends in mental health issues, including suicidal ideation and behaviors, among college students in the U.S. between 2008 and 2018. The researchers found that rates of depression, anxiety, suicidal ideation, and self-harm increased significantly over this period, not only for the college population in general but also for subgroups defined by sexual orientation and gender identity. They also found that while some disparities in these mental health outcomes have narrowed over time, others have widened, particularly for bisexual and pansexual students. This study highlights the need for increased prevention and intervention efforts to address the growing mental health needs of SGM young people.
College of Health researcher(s)
College unit(s)
Abstract
Prevalence estimates of mental health problems including suicidal thoughts and behaviors among college students have increased over the last decade, but time trends for sexual and gender minority (SGM) students remain undocumented. We compared trends in the adjusted prevalence of these outcomes by gender and sexual orientation in college students (n = 816,461) ages 18–24 years sampled from 4-year colleges that self-selected to participate in the cross-sectional National College Health Assessment in 2008–2018. Prevalence of 30-day depressive and anxiety symptoms increased significantly for every group examined—cisgender women, cisgender women, transgender students, and heterosexual, gay/lesbian, bisexual/pansexual, and unsure/questioning students—and 30-day suicidal ideation increased significantly for all but transgender and unsure/questioning students. Disparities that sexual minority and transgender students showed relative to heterosexual and cisgender peers widened for depressive and anxiety symptoms, and the narrowing of disparities on suicidal ideation and past-year suicide attempt were explained by increases in prevalence among cisgender women and heterosexual students. A redoubling of prevention efforts, particularly for SGM young people, is needed to reverse recent trends in psychological distress and suicide risk.
Public Significance Statement
In this sample of more than 800,000 young adult college students in the United States, we found increases from 2008–2018 in the proportions of students reporting serious depressed mood, overwhelming anxiety, suicidal thoughts, self-harm, and suicide attempt. Moreover, we found increases across subpopulations defined by sexual orientation and gender, including transgender.
FAQ: Mental Health Trends in SGM College Students
What is the main finding of this study regarding mental health trends among college students in the U.S.?
This study found a significant increase in mental health issues, including serious depression, anxiety, suicidal thoughts, self-harm, and suicide attempts, among U.S. college students from 2008 to 2018. These increases were observed across all examined subgroups, including cisgender men, cisgender women, and transgender students.
Are there differences in mental health outcomes between sexual and gender minority (SGM) and non-SGM college students?
Yes, the study found significant disparities in mental health outcomes between SGM and non-SGM college students. SGM students, particularly transgender students and those identifying as bisexual, pansexual, or queer, consistently reported higher rates of mental health problems and suicide risk indicators than their heterosexual and cisgender peers.
What factors might explain the higher prevalence of mental health problems among SGM college students?
The study suggests that minority stress, stemming from experiences of homophobia, transphobia, discrimination, and victimization, significantly contributes to poorer mental health outcomes among SGM students. Additionally, feelings of less connectedness and belongingness, higher substance use rates, and prior histories of self-harm or suicide attempts can also heighten their risk.
How have disparities in mental health outcomes between SGM and non-SGM students changed over time?
While there has been a narrowing of disparities in self-harm, suicidal ideation, and suicide attempt rates, this is largely attributed to increases in these issues among cisgender women and heterosexual students. On the other hand, disparities in depressive and anxiety symptoms have widened, with bisexual, pansexual, queer, and transgender students experiencing more significant increases compared to their heterosexual and cisgender counterparts.
What are the implications of these findings for college campuses and communities?
These findings highlight the urgent need for increased mental health resources and support services specifically tailored to the needs of SGM college students. Colleges should focus on addressing barriers to mental health service utilization reported by SGM students, improving access to trusted clinicians with SGM expertise, and creating inclusive and supportive campus environments.
What role can families, schools, and society play in addressing mental health disparities among SGM youth?
Early intervention and prevention efforts are crucial to addressing mental health challenges among SGM youth before they enter college. Families, schools, and communities should actively promote SGM acceptance, provide access to appropriate mental health services, and work to reduce minority stress through legal protections and social support systems.
Was there anything unexpected in the study's findings?
The study found similar rates of suicidal ideation and suicide attempts between cisgender men and women in college, which contrasts with previous studies showing higher rates among women in other populations. This suggests that factors unique to the college environment, or potentially the accounting for individual-level covariates including sexual orientation, may influence these outcomes.
What are the limitations of this study?
The study acknowledges limitations related to the generalizability of findings due to institutional self-selection for participation and low student response rates in the NCHA survey. Additionally, the validity of mental health measures and the potential impact of changes in SGM identity measures over time are noted as areas for further consideration.